Provider Demographics
NPI:1942400957
Name:CIFUENTES, CINDY ELIZABETH (RN)
Entity Type:Individual
Prefix:MS
First Name:CINDY
Middle Name:ELIZABETH
Last Name:CIFUENTES
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:179 SUNFLOWER LN
Mailing Address - Street 2:
Mailing Address - City:ISLANDIA
Mailing Address - State:NY
Mailing Address - Zip Code:11749-1616
Mailing Address - Country:US
Mailing Address - Phone:631-582-3125
Mailing Address - Fax:
Practice Address - Street 1:179 SUNFLOWER LN
Practice Address - Street 2:
Practice Address - City:ISLANDIA
Practice Address - State:NY
Practice Address - Zip Code:11749-1616
Practice Address - Country:US
Practice Address - Phone:631-582-3125
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-19
Last Update Date:2007-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY338389-1163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02063261Medicaid